Low Blood Glucose Can Be Highly Dangerous

Endocrinologists and other scientists are working on ways to help people with diabetes avoid the risks of low blood sugar. (NAPS

(NAPSI)-if you or someone you care about is among the more than 29 million Americans living with diabetes of the additional 86 million who are at risk for developing the disease—there’s something you should know.

The Problem

One complication of diabetes, hypoglycemia, occurs most often in people taking medications as treatments that may raise insulin levels too high, which can cause blood glucose levels to drop too low. Hypoglycemia can be dangerous and, depending on the severity, can lead to various symptoms including dizziness, confusion, anxiety, seizure or loss of consciousness.

It’s a particular problem in hospitalized patients. Low blood sugar, also known as hypoglycemia, is associated with increased short- and long-term mortality risk, per a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

To increase awareness of hypoglycemia in persons with diabetes mellitus and to foster initiatives focused on reducing its incidence, the Endocrine Society established the Hypoglycemia Quality Collaborative (HQC), a coalition of medical specialty societies, payers, industry, patient advocates, diabetes educators and research organizations.

Seeking Answers

“Hypoglycemia is common among hospitalized patients with and without diabetes mellitus,” explained the study’s senior author, Amit Akirov, M.D., of Rabin Medical Center in Petah Tikva, Israel. “Our findings suggest that hypoglycemia, whether insulin related or noninsulin related, is associated with short- and long-term mortality risk.”

The study included nearly 3,000 patients with hypoglycemia, defined as blood glucose levels < 70 mg/dL, during hospitalization at a 1,330-bed, university-affiliated medical center. Researchers evaluated medical records and the hospital’s mortality database to investigate the association between hypoglycemia and mortality in hospitalized patients. They found that for patients with hypoglycemia, end of follow-up mortality was 31.9 percent.

Mortality risk was higher in insulin-treated patients with moderate hypoglycemia (40−70 mg/dL), compared to patients without insulin treatment with similar glucose values. However, with severe hypoglycemia (<40 mg/dL), the increase in mortality risk was similar with insulin-related and noninsulin-related hypoglycemia. Cause of admission did not affect the association between glucose levels and mortality.>

“These data are a timely reminder that hypoglycemia of any cause carries the association with increased mortality,” said Akirov.

The new HQC blueprint provides recommendations and tactics in multiple strategic areas including reducing gaps in care, advocating for increased focus on hypoglycemia, and improving quality of care for patients who experience hypoglycemia.

Suggested Solutions

Recommendations include:

• Federal government should increase funding for research at the National Institutes of Health and the Centers for Disease Control and Prevention to reduce gaps in evidence related to hypoglycemia prevention and management;

• Insurance companies and health care providers should look for ways to incorporate continuous glucose monitoring data into clinical decision making to prevent and manage hypoglycemia in high-risk individuals;

• Diabetes educators, patient advocacy groups and social workers should engage patients and caregivers regarding self-management techniques as well as protective rights in the workplace; and

• Hypoglycemia-specific education should be targeted by age and gender, sensitive to the amount of time a patient has available, and include training from behaviorists, nurses, dietitians and exercise physiologists.

Endocrinologists are at the core of solving some of the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions. The Society, which is celebrating its centennial, has more than 18,000 members, including scientists, physicians, educators, nurses and students.

story source :tucsonlocalmedia.com

Exercise vs. Diabetes: New Information Shows a 40% Drop in Diabetes Progression

Using data from more than 1 million participants across four continents, researchers measured the precise benefits of exercise.

We have spent billions of dollars and performed thousands of studies to prove that exercise is an important part of diabetes treatment.  Yet most patients with diabetes do not exercise on a regular basis.

Diabetes in the United States is reaching epidemic proportions. Almost 1 in 10 Americans are estimated to have diabetes — that is more than 29 million people. Plus another 90 million are thought to have prediabetes, a state where an individual’s blood sugar level is higher than it should be, but not high enough to trigger a diabetes diagnosis. It is considered an early warning signal.

With the global number of type 2 diabetes cases expected to hit 592 million by 2035, all knowledge of how this disease might be managed is vital.  The risk factors for type 2 diabetes (the most common version of diabetes) are well known.

Being overweight or obese, high blood pressure, abnormal cholesterol and triglyceride levels, and inactivity are all known to play a substantial role. All of the above can be managed, at least in part, by exercise.

In a fresh look at the benefits of exercise, a new study, published recently in the journal Diabetologia, takes a deeper look at the role of exercise in the development of type 2 diabetes. It is the most in-depth study to examine exercise independent from other influential factors, such as diet. The conclusions from the report are clear:  According to co-author Dr. Soren Brage: “This research shows that some physical activity is good, but more is better.”

Currently, physical activity guidelines in the U.S. and the United Kingdom recommend 150 minutes of moderate activity or 75 minutes of vigorous activity per week; this could include cycling, walking, or sports. However, according to the Centers for Disease Control and Prevention (CDC), fewer than 50 percent of American adults meet these recommendations.

The current study was a result of collaborative work between two institutions — the University College London and the University of Cambridge, both of which are based in the U.K. Data from more than 1 million people was collated. In all, the team analyzed 23 studies from the U.S., Asia, Australia, and Europe.

Thanks to the vast amount of information available to them, the investigators were able to strip out the effects of exercise and examine them independently of other behavioral factors, such as diet and smoking. This is in contrast to earlier work that has not been able to isolate the impact of physical activity alone.

The researchers found that any exercise is beneficial in staving off diabetes, but individuals who exceeded the 150 minute recommendation saw the greatest benefits, so more is better.

According to the analysis, cycling or walking briskly for 150 minutes each week cuts the risk of developing type 2 diabetes by up to 26 percent.

Those who exercise moderately or vigorously for an hour each day reduced their risk by 40 percent. At the other end of the scale, for those who did not manage to reach the 150 minute target, any amount of physical activity they carried out still reduced the risk of type 2 diabetes, but to a lesser extent.

The results suggest a major potential for physical activity to slow down or reverse the global increase in type 2 diabetes and should prove useful for health impact modeling, which frequently forms part of the evidence base for policy decisions.

“Exercise has long been known to reduce the risk of developing type 2 diabetes; however, now we have a clearer picture of the exact figures behind this effect,” said lead author Andrea Smith.

Co-author Brage said: “These new results add more detail to our understanding of how changes in the levels of physical activity across populations could impact the incidence of disease. They also lend support to policies to increase physical activity at all levels. This means building environments that make physical activity part of everyday life.”

Practice Pearls:

• Percent of adults 18 years of age and over who met the Physical Activity Guidelines for aerobic physical activity: 49.0%
• Percent of adults 18 years of age and over who met the Physical Activity Guidelines for both aerobic physical and muscle-strengthening activity: 20.9%
• Those who exercise moderately or vigorously for an hour each day reduced their diabetes risk by 40 percent.

Physical activity and incident type 2 diabetes mellitus: a systematic review and dose–response meta-analysis of prospective cohort studies, Soren Brage et al., Diabetologia, published online 17 October 2016.

story source :diabetesincontrol.com

7 of the Best Fruits for Diabetics

Fruits are the perfect foods

They are loaded with nutrients and fiber, relatively low in calories and easy to bring to work.

However, they do contain naturally occurring sugars, sometimes in large amounts. This can be a concern for those who struggle to control their blood sugar

This article takes a science-based look at the most suitable fruits for those with diabetes.

1. Blueberries

Blueberries are quite low in sugar, with 10 grams per 100 grams of fruit 

But that sugar is also accompanied by 2 grams of fiber. This is important because when sugar and fiber are eaten together, blood sugar levels don’t spike as quickly 

It’s the reason 10 grams of sugar from fresh fruits will not have the same effect on blood sugar levels as 10 grams of sugar from a candy bar.

In addition, blueberries provide loads of other beneficial nutrients and antioxidants that protect our cells from damage.

Interestingly, a study on over 187,000 people tracked over two decades found those who ate the most blueberries had more than a 25 percent lower risk of getting diabetes than those who ate the fewest 

Blueberries are great for a snack, and you can even enjoy them in salads. Although they can be particularly expensive, know that frozen blueberries are still nutritious and often much more affordable.

2. Strawberries

Strawberries contain even less sugar than blueberries, with only 5 grams per 100 grams of fruit 

This makes them a great choice for diabetics.

They also provide fiber, manganese, folate and a lot of vitamin C. In fact, 100 grams of strawberries (5-6 large strawberries) provides 98 percent of our daily vitamin C requirements.

Strawberries are a great addition to breakfast foods like oats or yogurt, but they are also delicious on their own.

3. Blackberries

Of all the berries, blackberries stand out most.

Per 100 grams of fruit, they contain only 5 grams of sugar and an impressive 5 grams of fiber 

High fiber diets help with glucose (sugar) metabolism, and can improve insulin sensitivity too.

More fiber also improves other health issues related to type 2 diabetes, such as high LDL cholesterol and weight management 

Blackberries are slightly more tart than the other berries, but are typically eaten in the same way.

4. Grapes

Grapes contain 16 grams of sugar per 100 grams of fruit, which is more than other in this list 

However, research has found that those who ate the most grapes had 12 percent less chance of developing type 2 diabetes than those who ate the fewest 

Of course this is only observational research (does not prove cause and effect), but many scientists genuinely believe there is something special about grapes.

It may have something to do with the polyphenols in grapes, which have been shown to have positive effects on blood sugar levels 

Grapes make an easy snack, but are not low in sugar. So they should definitely be eaten in place of, rather than in addition to, another less-healthy snack.

For example, replacing a flavored yogurt or bag of chips would be a healthy step up

5. Apples

An apple contains about 10 grams of sugar per 100 grams, equal to one very small apple 

It also has about 2 grams of fiber, most of which is in the peel.

Like blueberries and grapes, apples are linked with a reduced risk of diabetes. But they’re also linked with a lower risk of stroke, which is a huge risk factor for those with type 2 diabetes 

One study that tracked almost 75,000 people for over 10 years found those who ate the most apples and pears had an 11 percent reduced risk of stroke 

The main takeaway is that apples are a healthful addition to your diet, with or without blood sugar issues. The fact they are affordable, convenient and delicious is just a bonus.

6. Watermelon

Watermelons seem high in sugar, but actually only has 6 grams of sugar per 100 grams 

This because of its high water content, which also keeps it low in calories.

Watermelon is also a great source of lycopene. This phytochemical has been shown to improve sensitivity to insulin, lower blood sugar and lower risk of type 2 diabetes 

Just be mindful of the amount you eat at each serving because it’s easy to over-indulge.

Not only does the sugar content can add up, but watermelon is high in FODMAPs that can cause digestive stress (especially those with IBS).

7. Avocado

Not a fruit in the culinary sense, but avocados are a great choice for people with diabetes.

They contain zero sugar and a whopping 7 grams of fiber per 100 grams 

Even better, they are high in healthy monounsaturated fats. Research has shown that diets low in poor quality carbohydrates and high in monounsaturated fats can improve insulin sensitivity 

Avocados are great in a salad or as a dip. They are even delicious on their own; just add a pinch of salt to taste.

The Best Fruits For Those With Diabetes Are In Whole Form

With relatively few calories and lots of important nutrients, whole fruits are one of the great options for people with diabetes.

Some varieties can be high in sugar though, so they are best eaten in place of – rather than in addition to – less healthy foods.

Fresh, frozen, or canned fruits are all healthy choices, but be sure to avoid fruits canned with added sugars or syrups.

Fruit juices are also not a good option because they are an unnaturally concentrated source of fruit sugar, without the beneficial fiber. For example one apple juice can be made of 4 or more apples (usually peel is removed), yet you would never be able to eat 4 apples in one sitting.

This post originally appeared on Diet with Disease

Vital nutrients for diabetes

Are you suffering from high blood glucose levels?

You are not alone, as according to the International Diabetes Federation (IDF), there were already 415 million sufferers worldwide as of 2015, which means one in 11 adults worldwide have diabetes.

This figure is expected to rise to a staggering 642 million by the year 2040.

Another frightening statistic from IDF worth mentioning is that every six seconds, one person dies from diabetes. Five million deaths recorded in 2015 were caused by diabetes.

How disturbing is that?

Reverse your diabetes: You can stay diabetes-free long-term

A new study from Newcastle University has shown that people who reverse their diabetes and then keep their weight down remain free of diabetes.

In addition, the team found that even patients who have had Type 2 diabetes for up to 10 years can reverse their condition.

The study, published in Diabetes Care, is the latest research from Professor Roy Taylor, Professor of Medicine and Metabolism at Newcastle University, who also works within Newcastle Hospitals.

The research is part of a growing body of evidence showing that people with Type 2 diabetes who successfully lose weight can reverse their condition because fat is removed from their pancreas, returning insulin production to normal.

World Diabetes Day: Here's everything you need to know 

Here, four doctors share their prescriptions with Saliha Nasline. The bottomline is discipline in diet, exercise and regular monitoring 

Dr V Mohan, Chairman, Dr Mohan's Diabetes Specialities Centre, Chennai 

The late Ravi Baskaran, one of our oldest patients, who was diagnosed to have diabetes in his teenage. He was started on insulin injections several times a day which he meticulously took all his life. He maintained good control of diabetes in the initial years by painstakingly checking his urine sugar by the good old Benedict solution method. After several years, he had moved to blood glucose testing using a glucometer. All his life, he maintained very good health and did not develop any of the diabetes-related complications.He led an active life in the corporate world as he was a management consultant. He was an ardent cricketer and had played league cricket at the same level. After over 62 years of active diabetic life, Ravi finally died at the age of 76 years, not due to diabetes

Managing diabetes 

We have had many cases of children developing diabetes when they are one or two years old. But they have grown up to excel in their professions, get married, have children and are still alive after 60 or 70 years of diabetes. All these patients have followed a strict discipline by maintaining their exercise schedule, taking their medicines or their insulin regularly and visiting the diabetes centre for regular check-up and advice. 

Treatment 

The treatment style for a patient diagnosed with diabetes for the first time will depend on the type of diabetes. In the case of type 2 diabetes, which constitutes 90-95% of all patients with diabetes, diabetes can be managed by diet, exercise and tablets. In the case of insulin-dependent, type 1 diabetes, insulin injections would be needed several times a day and in the case of certain other forms of diabetes, based on the specific type of diabetes, there could be some variation in the treatment given. However, in all cases, discipline is very important to maintaining a strict diet schedule, regular exercise, medication and self-monitoring. 

Dr Ankush Gupta, ConsultantGeneral Medicine, DocsApp 

The son of a 60-year-old patient asked about his father's diabetes for second opinion on DocsApp. One month back he was all normal and suddenly sugar levels were high in the recent test. We asked all the details about the patient, understood present medication, types of insulin and quantity of insulin, saw the prescriptions and other reports, which were uploaded on the website. 

A doctor suggested some course of medicine, lifestyle changes and diet changes and asked the patient to get the test done again after five days. Later, the doctor changed the levels of insulin, according to the blood sugar values regularly for two months, monitoring his lifestyle changes as well. After two months, the patient's blood sugar became normal, he is still continuing the medication without any insulin injection. 

He is able to maintain the sugar level, with proper diet and lifestyle changes suggested by the doctor. 

Treatment 

There are two types of diabetes mellitus. Type 1 is insulin dependent because of absolute lack of insulin. Type 2 usually occurs in people who are over 40 and overweight. There is no lack of insulin but peripheral cells are resistant to insulin. Dietary restriction, exercise and controlling insulin levels are the cornerstones of the management of type 1 diabetes. 

Weight reduction, dietary restrictions, and exercise are also proven ways to increase insulin sensitivity in type 2 diabetes. If optimal control of blood glucose levels is not achieved with weight reduction programme, drug therapy is started. 

Diabetes is a lifestyle disease which occurs due to sedentary lifestyle and bad dietary habits.So lifestyle changes form an important part of treatment of diabetes. Avoiding oily , fried foods, food with high glycemic index (sugar, sweets) and taking small regular meals at regular intervals is important. Daily 30 minutes of brisk walking five days a week is important to reduce weight. 

Drug therapy is started mostly after three months of lifestyle management, if optimal control of blood glucose is not achieved.Regular follow-up with at least one follow-up for three months is needed to check the blood sugar levels and modify medication accordingly 

Management 

Regular follow-up is very important. Blood sugar level goes up and down depending on the patient's weight gain or loss, dietary changes and sensitivity to medicines. Normally , follow-up is done after three months to check if medicines are working and whether the patient is following the suggested lifestyle changes or not. 

The dose of the medicine can be increased or decreased depending upon the blood sugar level or the medicine can be changed if it is associated with side effects or optimal sugar level is not achieved. In essence, maintaining lifestyle changes, weight reduction, dietary changes, taking medicines at regular intervals as prescribed and keeping a regular follow-up schedule with the doctor will keep the sugar levels and diabetes in control. 

Dr Srinivasa P Munigoti, Consultant Diabetologist & Endocrinologist, Fortis Hospital, Bengaluru 

37 -year-old Sudeep (name changed) is banking pro fessional from Gujarat.He was unaware of his condition and could not understand the reason for his excessive thirst and increased urination. After check ups, he came to realise that he had type 2 diabetes with high levels of sugar. Even though his family had no history of the condition, his weight of over 100 kg added to his problem. He was on strict diet to control his diabetes and he had to maintain a healthy intake of 1,200-1,400 calories on a daily basis coupled with physical exercise. He was able to run close to 35 km per week. With regular exercise and diet routine, Sudeep has fought the disease and is off medications for diabetes today . As an end result, he has not only taken control of his sugar levels but has also lost 20 kg. He has even participated in marathons. An early diagnosis, a change in his erratic lifestyle and healthy eating helped this young professional re gain control on his life. 

Managing diabetes 

Diabetes can be managed well by adopting the right lifestyle changes and following medical advice that may include various medications, regular tests and follow-up with doctors. 

Treatment 

Treatment of diabetes is a holistic approach, a lot of factors need to be kept in mind. A patient has to be assessed based on his lifestyle, socioeconomic background, support sys tem, age, etc. However, on the whole, a patient should be educated about what diabetes is, its complications and what measures are to be taken for it. It has to be well explained that it is not a curable disease but only one that can be controlled with diet, exercise and compliance with medicines. Another key factor is identification and management of stress. 

Management

It is a game of will power for the control of sugars through diet and exercise. A lot of them go on very strict diet and exercise when they are diagnosed with high sugars, and after some time, they give up on it. Hence it is necessary to understand that it requires a great effort, which has to be sustained in the long run. Those who manage to do regular exercise and healthy diet bring down their sugars well. 

Many a time, when patients come to know about their sugar levels for the first time, they are in the state of shock or denial. It is very important to know what to tell the patient and how much of information they can take in such a state of mind. The treatment, whether it has to be on only lifestyle or medicines depends on the severity of the diabetes. 

NEWS REPORT : economictimes.indiatimes.com

You Need to Know About Diabetes

November 14 is World Diabetes Day and the theme this year is “Eye on Diabetes.” When my brother-in-law, who appeared to be extremely healthy, was diagnosed with a pre-diabetes condition recently, I realized that this disease can strike anyone. That’s why the International Diabetes Day(IDF) is focusing its efforts this year on the importance of screening to ensure early diagnosis and treatment of type 2 diabetes.

Here are 10 things you need to know about diabetes